The biggest limiting factor for the MIS spinal device market is the complexity of the procedures and the skill required to master them. In particular, percutaneous techniques and, to a lesser extent, retractor techniques are considered by many to be considerably more difficult to master than traditional open surgical methods. Older generations of doctors and surgeons are especially reluctant to switch to MIS, as it takes a considerable time investment to master the procedure.

One of the key drivers for the MIS spinal device market is the increase in the target population. Both fusion and non-fusion procedures are typically performed in order to treat spinal complications that are much more common in elderly patients. Across Europe, the percentage of those over 50 years of age comprises approximately 34% of the total population. Over the next 20 years, this percentage is expected to increase by nearly 10%. The growth of this population is expected to stimulate growth in both fusion and non-fusion spinal implant markets.

The MIS interbody market continues to see a shift toward OLIF and LLIF devices and away from MIPLIF and MITLIF devices. The oblique and lateral lumbar approaches are expected to see more growth than their posterior and transforaminal lumbar counterparts, although positive growth is expected across segments.